Individual provider Active NPI

Maryann Kuzma, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1083662308
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD034433E Issued in PA
Practice address
2126 Fairmount Ave
Philadelphia, PA 19130-2603
Phone
(215) 236-4600
Fax
(215) 236-4609
NPI assigned
May 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD034433E PA Primary

Addresses

Primary practice location

2126 Fairmount Ave
Philadelphia, PA 19130-2603

Mailing address

1601 Cherry St
Suite 11511
Philadelphia, PA 19102-1321
Phone (215) 255-7822

Other identifiers 1

IdentifierTypeStateIssuer
001119497MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050721000526 PA Practitioner - Internal Medicine 7012944044 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Drexel UniversityGroup PAC ID 5496664740, 80 clinicians

Practice addresses (Care Compare)

1427 Vine St
Philadelphia, PA 19102-1031

219 N Broad St 6TH Floor
Drexel Internal Medicine
Philadelphia, PA 19107-1519
Phone (215) 762-5037

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Drexel Academic Medical Group LLC CurrentSince Apr 1, 2020 Accepting new patients
Tower Drexel Academic Medical Group LLC CurrentSince Apr 1, 2020 Accepting new patients
Tower Drexel Academic Medical Group LLC Internal Medicine Current Accepting new patients
Drexel University Current Accepting new patients
Drexel University CurrentSince Jul 1, 2014 Accepting new patients
Drexel University Past Accepting new patients

Locations

1427 Vine St
Fl 8
Philadelphia, PA 19102
Phone (215) 762-6660

219 N Broad St
Fl 9
Philadelphia, PA 19107
Phone (215) 762-2688

1601 Cherry St
Ste 11511
Philadelphia, PA 19102

219 N Broad St
Fl 6
Philadelphia, PA 19107
Phone (215) 762-5037

Interoperability endpoints

  • Direct secure messaging: mkuzma18841@drexel.gardenplot.direct-ci.com
  • FHIR API: https://epicproxy.et4001.epichosted.com/APIProxyPRD/api/FHIR/R4

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1083662308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CHERRY ST",
            "address_2": "SUITE 11511",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021321",
            "telephone_number": "215-255-7822",
            "fax_number": "215-255-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2126 FAIRMOUNT AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191302603",
            "telephone_number": "215-236-4600",
            "fax_number": "215-236-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUZMA",
        "first_name": "MARYANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD034433E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001119497",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.